Patients’ Perception of Vitiligo Severity
Nanja van Geel, Charlotte Moock, Marloes Zuidgeest, Sanne Elisabeth Uitentuis, Albert Wolkerstorfer, Reinhart Speeckaert
Identifying which factors contribute to vitiligo severity and determining their individual weight are important in the management of vitiligo. The aim of this study is to investigate the predictive variables concerning vitiligo severity as perceived by the patients. Based on a questionnaire, several factors that may contribute to the Patient Global Assessment (PtGA) of severity were investigated within a Belgian vitiligo population (n = 291). In addition, possible factors influencing vitiligo severity were scored and ranked. The strongest correlations with the PtGA of severity were found for impact, Dermatology Life Quality Index and disease extent. Based on multivariable regression analyses, 64.7% of PtGA of severity could be predicted by subjective and objective variables, while 32% could be explained by objective clinical features only. Patients considered lesion location, extent and disease activity as the most important contributing factors to severity. Vitiligo severity is determined by objective clinical features, but also, for a significant part, by the perceived impact of the disease.
Understanding which factors determine the severity of vitiligo from a patients’ perspective is crucial to choose the right treatment for the individual patient. Traditionally, the extent of the disease, has been considered the main factor that influences the severity of vitiligo. This study found that a combination of several objective clinical features (e.g. extent, skin type, disease activity) explains 32% of the variation in perceived disease severity, and that personal subjective factors (e.g. perceived disease impact) explain another major part. These findings are important for the management of vitiligo and stratification of patients in treatment guidelines.